Month: February 2014

After my first ‘asshole of the day‘ post, the recipient, Mr George Dawson- an American psychiatrist and blogger, responded through his blog. First of all, before I respond to his response, I would like to correct Dawson:

Dr Dawson, your ‘response’ to my comments on your blog came after I had done the blog post (check the dates and you will see this) not before, secondly, the blog post had more to do with your general disdain and disparaging attitude towards psychiatric system users (in other words your patients- people like me!) than Peter Gotszche’s rebuttal.

Furthermore, the problem is you label everyone who disagrees with you as ‘anti-psychiatry ‘ and you think that by doing so automatically disqualifies their opinion. This is ironic considering you also believe that the same people that you label as anti-psychiatry, think that all psychiatrists are jerks, therefore (according to this silly logic) anything coming from a psychiatrist must, and will be, ridiculed by ‘anti-psychiatrists’. The reductive mind set which you accuse those who disagree with you of possessing, is the exact same reductive mind set which you approach them with. Once you have decided that someone is anti-psychiatry you immediately become defensive, and you see that person or entity as a threat. This creates hostility.

This is also the crux of the problem.

I am not anti-psychiatry, but I do have a number of issues with the ideology of psychiatry, I also think that there are major flaws in the psychiatric system. You think that there is a simple division of beliefs, between the so called ‘anti-‘psychiatrists, and psychiatrists themselves. What you fail to see is that the issues are immensely more complex, this is not black and white, and the debate has many shades of grey on all sides. And I say, ‘all sides’, because I do not believe that there are merely two opposing sides. There are variants and they often overlap. There are many sides. Many many perspectives. Many voices.

If I was anti-psychiatry, I would not be supporting and championing the opinions of Dr Peter Breggin, Dr David Healy, Dr Corry and others. They are psychiatrists and I like them. I trust them, and I value their opinion. But perhaps you would label them ‘anti-psychiatry’? If so, then that is even more ridiculous, because they are practicing psychiatrists so how can they be anti-themselves or somehow anti-their profession. It simply is nonsensical. They are certainly offering different perspectives than most mainstream psychiatrists, but it is not accurate to label them anti-psychiatry. It’s absurd.

This labeling reminds me of the post-911 labeling of liberals, or those who disagreed with Bush’s policies- as somehow inherently ‘anti-American’. These are semantic tricks and sophist charades, which serve only to shut down debate, and in many ways that is the intention.

Dividing everyone into either a pro-psychiatry, or anti-psychiatry camp, is convenient for black and white thinking, but it does not reflect the realities of the debate. It is very simplistic binary-type logic which serves only to create a situation where debate can easily be shut down, on one side, by applying the label of ‘anti-psychiatry’ on to someone that they think represents the other side. This type of engagement does little to advance insightful discourse.

Furthermore, the irony here is, even if someone is actually completely anti-psychiatry, in many cases they would have good reason to be, as the majority of those who identify more with anti-psychiatric discourse are people who have been through the psychiatric system, thus they would have every right to feel and express their thoughts of that system. Psychiatry gets negative criticism for good reason, as it often fails and damages people.

Most people don’t appreciate being duped, disappointed and damaged, particularly when that harm comes from the people who they entrusted with their health. The label of ‘anti-psychiatry’ is justifiably embraced by some who are harmed by psychiatry, because some of these people actually do detest the psychiatric ideology, and some utterly hate it. However, this ’emotive response’ from some does not automatically disqualify their experiences or their opinions. In many cases, it merely reflects that other very human trait: Courage. The strength to stand up and fight back.

By virtue of the fact that it is psychiatric patients, or those treated by psychiatrists, who are the service users, surely their opinion and input into debates and issues which affect them should be highly valued- not debased? By simply applying an anti-psychiatry label on psychiatric patients, or those damaged by psych drugs or ECT, some psychiatrists think they can just ignore their views. It conveniently creates the situation where whole swathes of psychiatric service users’ experiences becomes invalid and unworthy of engagement. This is wrong, and so arrogant of the psychiatric profession, and it is why I posted the post in the first place. Your profession is extremely well paid, the least you could do is put some value on those who you ‘treat’ with it, whether they are critical or not should not even come into it…

I will respond to your comment on Paroxetine in due course…

(and by the way, I have never been paid one cent either by anyone, this blog is completely independent as am I, it is primarily for those who seek information on Seroxat. I put the Bitcoin thing up this year, and have yet to receive any donations, and I don’t expect any either, it was merely hoping for some kind gestures as the blogging is hard work, I have done this to help people for seven years and I am unpaid. Also I think it is a bit ridiculous that you claim that you have no conflict of interest, you are a psychiatrist, it’s your job, you get paid to promote the ideology of psychiatry and you certainly seem to invest a lot of time defending it. It’s your bread and butter though so why wouldn’t you? But claiming no conflict of interest is ridiculous because it is in your interest that people believe psychiatry works otherwise you wouldn’t have your big salary)

ps.. not all psychiatric drug users’ experience is ranting from the ‘uneducated masses’, as one of your supporters recently described us on your blog in the comments section…

Personally, I thought that was an extremely derogatory and condescending statement, the fact that you didn’t take issue with it (and likely didn’t even notice it) was very evident by your blasé response. This speaks volumes and pretty much backs up my intuition about you in my original post…

GSK, Rolls-Royce may be on British Serious Fraud Office’s hit list

Glaxo and Rolls-Royce may be on the hit list as a new policy will make it easier to deal with cases involving malpractice overseas efficiently

PUBLISHED : Friday, 21 February, 2014, 10:53am

UPDATED : Saturday, 22 February, 2014, 12:05am

GlaxoSmithKline may be one of the likely targets in the bribery probes launched by Britain’s Serious Fraud Office. Photo: AP

Britain’s Serious Fraud Office plans to prosecute or fine some companies for engaging in bribery overseas, and analysts said some cases might involve mainland China, with GlaxoSmithKline and Rolls-Royce as likely targets.

“We have a number of cases in mind but need to look at all the facts,” a spokesman with the fraud office told the South China Morning Post.

The Bribery Act seeks to punish Britain-linked firms for bribery overseas, and a new policy by the office announced this month could make it easier to deal with such cases efficiently.

We are investigating cases that risk being overlooked as too difficult

BEN MORGAN, SERIOUS FRAUD OFFICE

The timing of the prosecutions and fines would depend on the circumstances of individual cases, the spokesman said.

In a speech in November quoting Chinese President Xi Jinping’s anti-corruption slogan “Striking tigers as well as flies”, Ben Morgan, the joint head of bribery and corruption at the office, said: “We are investigating the types of cases that risk being overlooked as too difficult or too sensitive.”

Rob Elvin, a Britain-based managing partner of law firm Squire Sanders, said: “We assume this includes GlaxoSmithKline and Rolls-Royce.”

Beijing is probing GSK, the largest British drug firm, for alleged bribery in mainland China.

In December 2012, Rolls-Royce, which makes civil and military jet engines and power generation equipment, said it had passed information to the fraud office relating to bribery, in response to the office’s request for information about allegations of malpractice in Indonesia and mainland China.

The British company said it had identified “matters of concern” in mainland China, Indonesia and other countries.

A Rolls-Royce spokesman declined to comment on media reports that businessman Sudhir Choudhrie and his son Bhanu were arrested in London this month as part of the office’s investigation into alleged bribery in Indonesia and mainland China by the firm.

The spokesman also declined to comment on reports in London’s Daily Telegraph that the fraud office’s probe included contracts won by Rolls-Royce after the Bribery Act came into force in 2011.

“If any investigation [by the fraud office] did uncover problems after July 1, 2011, they could be covered by the Bribery Act, which makes it easier to prosecute,” said Barry Vitou, a partner at law firm Pinsent Masons, referring to the Rolls-Royce concerns.

Analysts said the office’s new deferred prosecution agreement policy would speed up prosecution of corruption cases. From Monday, these agreements for economic crimes would be available to British prosecutors, the office said last week.

A deferred prosecution agreement is one between the prosecutor and a company that allows prosecution to be suspended for a period of time, provided the firm meets certain conditions.

The fraud office’s director David Green said such an agreement sought to avoid damaging the company too much, which would hurt employees and shareholders.

The new policy was significant as it provided additional tools for prosecutors, said Andrew Dale, a partner at law firm Orrick, Herrington & Sutcliffe.

These agreements would potentially enable the fraud office to resolve more investigations more efficiently, said Keith Williamson, head of forensic and dispute services for Asia at Alvarez & Marsal, an international professional services firm. “We may see a [spate] of resolutions, either settlements or prosecutions,” he said.

Deferred prosecution agreements would encourage companies to voluntarily report corruption within their ranks to the fraud office, Williamson said.

Elvin said: “[These] agreements are most certainly significant. They allow commercial organisations to settle allegations of criminal economic activity without being prosecuted and without any formal admission of guilt. [They] provide a cost-efficient and quick means of addressing financial crime by corporates.”

However, British authorities were likely to still prosecute the most serious economic crimes, he said.

This article appeared in the South China Morning Post print edition as UK fraud office probes firms over bribery

On 6 January 2014, I published the article “Psychiatry Gone Astray” in a major Danish newspaper (Politiken), which started an important debate about the use and abuse of psychiatric drugs. Numerous articles followed, some written by psychiatrists who agreed with my views. For more than a month, there wasn’t a single day without discussion of these issues on radio, TV or in newspapers, and there were also debates at departments of psychiatry. People in Norway and Sweden have thanked me for having started the discussion, saying that it’s impossible to have such public debates about psychiatry in their country, and I have received hundreds of emails from patients that have confirmed with their own stories that what I wrote in my article is true.

Three months earlier, I gave a one-hour lecture about these issues in Danish, which was filmed and put on You Tube with English subtitles: http://www.youtube.com/watch?v=i1LQiow_ZIQ. After only two weeks, it had been seen by over 10,000 people from over 100 countries.

What this tells me is that I must have hit something that is highly relevant to discuss. I therefore translated my article and David Healy uploaded it on his website: http://davidhealy.org/psychiatry-gone-astray/. It also came up on www.madinamerica.com, the website of the science journalist Robert Whitaker, who gives many lectures for psychiatrists and whose recent book, “Anatomy of an epidemic,” was an eyeopener to me, as was David Healy’s “Let them eat Prozac.”

On 8 February 2014, psychiatrist George Dawson wrote “An Obvious Response to ‘Psychiatry Gone Astray“‘ on his blog. Having read Dawson’s blog, I feel the final sentence in my article, which was not translated into English, becomes relevant: It will be difficult when the leaders in psychiatry are so blind to the facts that they will not see that their specialty is in deep crisis. It is also relevant to quote the opening sentences in my acticle:

“At the Nordic Cochrane Centre, we have researched antidepressants for several years and I have long wondered why leading professors of psychiatry base their practice on a number of erroneous myths. These myths are harmful to patients. Many psychiatrists are well aware that the myths do not hold and have told me so, but they don’t dare deviate from the official positions because of career concerns. Being a specialist in internal medicine, I don’t risk ruining my career by incurring the professors’ wrath and I shall try here to come to the rescue of the many conscientious but oppressed psychiatrists and patients by listing the worst myths and explain why they are harmful.”

I listed 10 myths in my article, which I shall repeat here, and will now rebut Dawson’s criticism of them. Dawson says that the myths I describe “are mythical in that they are from the mind of the author – I know of no psychiatrist who thinks this way.” As I have just indicated, there is no person as blind as he who will not see and no psychiatrist as deaf as he who will not listen. Everything I wrote in my article has been documented, most of it in my book “Deadly Medicines and Organised Crime,” and many responses on his own blog shows Dawson to be wrong.

Myth 1: Your disease is caused by a chemical imbalance in the brain

Dawson: “This is a red herring that is frequently marched out in the media and often connected with a conspiracy theory that psychiatrists are tools of pharmaceutical companies who probably originated this idea. What are the facts?”

The facts are abundant. Many papers written by psychiatrists have stated this, and it is also what most patients say that their psychiatrists tell them. I have lectured for patients and asked them, and every time most patients say they have been told exactly this hoax about a chemical imbalance. The drugs don’t cure a chemical imbalance; they create one, which is why it is difficult to get off them again.

Myth 2: It’s no problem to stop treatment with antidepressants

Dawson: “Another red herring.”

Dawson agrees that there may be “difficulty discontinuing antidepressants” but then tries to get off the hook by noting that this can also be seen with other drugs than psychiatric ones. Allow me to say that one illegal parking doesn’t make the next one legal. Dawson agrees with me but tries to say he doesn’t. Pretty weird.

Myth 3: Psychotropic drugs for mental illness are like insulin for diabetes

Dawson invents strawmen here, e.g. by saying “Am I getting prednisone for my asthma because I am deficient in prednisone?”

That’s totally off the point, as no asthma specialist would be as silly as many psychiatrists are. Again, most patients have told me that this is what their psychiatrists tell them, and professors of psychiatry have also propagated the myth publicly, e.g. in numerous interviews and in articles written by themselves.

Pardon me, but Dawson must be both blind and deaf to have escaped this, which psychiatrists say and write all the time. Dawson finds the argument “demeaning to anyone with a severe psychiatric disorder who is interested in staying out of hospitals and being able to function or trying to avoid a suicide attempt. Being able to adhere to that kind of plan depends on multiple variables including taking medications,” and he furthermore says that, “It is reckless to suggest otherwise and any psychiatrist knows about severe adverse outcomes that have occurred as a result of stopping a medication.” Whitaker has documented at length in his book that the increased use of psychotropic drugs has led to an explosion in the number of chronically ill patients on lifelong disability pension and he has also explained and documented the mechanisms behind this.

Myth 5: Happy pills do not cause suicide in children and adolescents

Dawson believes that I reveal my “antipathy to medication used by psychiatrists” by referring to antidepressants as “happy pills.”

Dawson plays the antipsychiatry card here, which is the ultimate trump card psychiatrists use when they have no valid arguments. I consider the term happy pill extremely misleading, as, for example, half of those treated get their sex life disturbed, which has led me to call them unhappy pills whose main action is to ruin your sex life. However, since everybody uses the term (instead of the cumbersome “selective serotonin reuptake inhibitors”), including many psychiatrists, I also use it. Dawson says he has never met a psychiatrist who calls antidepressants “happy pills,” but what can you expect of a man who seems to be both blind and deaf? Dawson claims that “saying that happy pills are a cause of suicide is the equivalent of saying that “sugar medicine” (insulin) is a cause of hypoglycemia that harms children and therefore it should not be prescribed.” What exactly does Dawson mean by this smoke and mirrors? It is a fact, which the FDA has demonstrated, that SSRIs increase suicidal behaviour up to age 40, and package inserts warn about the risk of suicide and recommend not using SSRIs in children and adolescents. Then why do psychiatrists use them in this age group? To use Dawson’s allegory, we wouldn’t use insulin if it increased blood glucose and the risk of dying in a diabetic coma.

Myth 6: Happy pills have no side effects

Dawson’s naivity with respect to the drug industry is heartbreaking. About the incidence of sexual problems caused by SSRIs, he refers to FDA data. But what is buried in FDA archives is not what the companies tell doctors. It is true when I write that companies have said that only 5 % get sexual problems. The true rate of sexual problems is above 50%, and there are reports that these disturbances might become permanent, which agree with rat studies where the rats showed less interest in sex long after they had come off the drugs.

Myth 7: Happy pills are not addictive

Dawson’s says that ‘antidepressants aren’t addictive’.

They surely are, as half of the patients have difficulty coming off them again even with slow tapering and experience similar symptoms as patients who try to come off benzodiazepines.

Dawson claims that SSRIs have no street value and will not make you high, and that my comparison with amphetamine is completely off the mark and consistent with my general lack of knowledge of addiction. Allow me to say that there are striking similarities between the effects of amphetamine and SSRIs and also to quote a few sentences from my book:

“In 2004, the FDA issued a warning that antidepressants can cause a cluster of activating or stimulating symptoms such as agitation, panic attacks, insomnia and aggressiveness. Such effects were expected, as fluoxetine is similar to cocaine in its effects on serotonin (73). Interestingly, however, when the EMA in 2000 continued to deny that the use of SSRIs leads to dependence, it nonetheless stated that SSRIs ‘have been shown to reduce intake of addictive substances like cocaine and ethanol. The interpretation of this aspect is difficult’(77). The interpretation is only difficult for those who are so blind that they will not see.”

“Until 2003, the UK drug regulator propagated the falsehood that SSRIs are not addictive, but the same year, the World Health Organization published a report that noted that three SSRIs (fluoxetine, paroxetine and sertraline) were among the top 30 highest-ranking drugs for which drug dependence had ever been reported (62).”

Myth 8: The prevalence of depression has increased a lot

Dawson and I seem to agree that there is hardly any true increase in the prevalence of depression. The apparent increase is caused by lowering the criteria for what is considered a depression. I also agree with his argument that since 80% of antidepressants are prescribed by primary care physicians we might call this “Primary care gone astray.”

Myth 9: The main problem is not overtreatment, but undertreatment

Dawson’s main argument is that we should not blame psychiatrists for the overtreatment but the primary care prescribers. Well, they are certainly to blame but so are the psychiatrists. Although the Danish National Board of Health recommends that only one antipsychotic should be used at a time, this is not the case. According to a report by the Board of Health, only half of patients with schizophrenia received one antipsychotic drug, one third got two drugs, and the rest got three, four or even more drugs.

Myth 10: Antipsychotics prevent brain damage

Dawson calls my arguments “More rhetoric.”

They are not. Leading psychiatrists have written this and tell their patients that they need to take the drugs in order to prevent brain damage, although it has been documented that antipsychotics cause brain damage in a dose-dependent manner. Dawson continues his futile attempts at killing the messenger: “He also talks about antipsychotic medication with the arrogance of a person who does not have to treat acutely psychotic people and incredibly talks about these drugs killing people.” These drugs do kill people. Doesn’t Dawson know this? I have estimated that Eli Lilly has killed 200,000 people with Zyprexa, and that is just one of the many antipsychotic drugs.

Dawson ends by saying: “At the end of this refutation what have we learned? I am more skeptical than ever of David Healy and his web site.” Dawson is very much against that Healy put my article on his website and he seems to suggest again that one illegal parking makes the next one legal: “It is well known in the US that the 20 year CDC initiative to control antibiotic overprescribing is a failure.” So what? That doesn’t let the psychiatrists off the hook, does it? I think a dose of self-criticism would help not only Dawson, but many other psychiatrists, and their patients.

Dawson finally says that:

“internists have enough to focus on in their own specialty before criticizing an area that they obviously know so little about. The author here also states that he is affiliated with the Nordic Cochrane Center and I think that anyone who considers the output of that Institute should consider what he has written here and the relevant conflict of interest issues.”

These are the words of a desperate man. Short of good arguments, Dawson shoots in all directions. I have done research on SSRIs for several years; had a PhD student who defended her thesis on SSRIs in 2013; have access to unpublished clinical study reports on SSRIs from the European Medicines Agency that no one else outside the agency have access to, and which tells a completely different story to that in published trial reports; and I therefore know more about these drugs than most psychiatrists do. I don’t have a clue what my relevant conflict of interest should be about. I have none! Finally, the Nordic Cochrane Centre, which I established 20 years ago when I co-founded the Cochrane Collaboration and whose director I have been ever since, is highly respected for its research. As an example, I have published more than 50 papers in the big five (BMJ, Lancet, JAMA, NEJM, Annals), which very few people in the world have done. So I think my credentials and my centre are okay.

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Some of my Irish readers might be familiar with the Irish hurling player, Conor Cusack? Conor made headlines in Ireland when he wrote about his depression and his experiences with psychiatry and psychiatric drugs in Ireland. Last Friday, Conor was interviewed on the Late Late Show, Conor was asked on the show, was he medicated as a result of his depression diagnosis?. He responded, “I went into the psychiatric system”… “I always just got the feeling with psychiatrists, they weren’t interested with my story, they were interested with my symptoms”… at which point, the presenter, Ryan Turbridy, quickly interrupted and stated, ” Psychiatry works for an awful lot of people, it doesn’t work for others”. Conor always felt that the pills weren’t working for him (at one point he was on 17 pills a day).

His last hope resulted in a consultation for ECT, at which Conor felt that this was definitely not the option for him. Deeply disappointed , he considered suicide, but luckily he eventually met a good psychologist who then brought him on the road to recovery.

Conor’s story would be familiar to anyone who has been cast upon the psychiatric merry-go round. In Conor’s case, his psychiatric misadventure lasted over ten years. After many diagnoses,psychiatric consultations, anxiety attacks, depressions, suicidal despair, pills, and belly aches, Conor abandoned psychiatry, got some therapy and eventually got on the road to recovery. Notice, how, like many people, he recovered after he exhausted the psychiatric route…

It seems that the psychiatric system does nothing but perpetuate the mental and emotional suffering for most people. The drugs do no good, particularly long term. For me, like for Conor, they made me 100 times worse. Psychiatrists make a very good living controlling this system of human suffering with diagnoses and drug regimes, but do they heal people? or make them worse?

Suicide is an epidemic in Ireland, how many of those suicides were under the care of psychiatry? How many were drug induced? How many people does psychiatry work for? Or more importantly, has psychiatry ever ‘worked’ for anybody?

Personally, I think that psychiatry kills, it is an extremely dangerous system to become ensnared in, and I think Conor was lucky that he escaped its sociopathic clutches..

(I’d also like to ask why Ryan Turbridy felt the need to interject and claim that psychiatry works for many people. This is a dubious claim and it seems to me that the national broadcaster still fears offending many of Ireland’s oppressive institutions- in preference to- the exposure of truth.)

Glaxo earnings triple despite China investigation

FROM INQUIRER WIRE SERVICES

LONDON – GlaxoSmithKline Plc. said Wednesday that fourth-quarter earnings nearly tripled and sales rose 5 percent even as an ongoing investigation hurt business in China.

Net income rose to 2.5 billion pounds ($4.1 billion) from 848 million pounds a year earlier, thanks partly to profits on the sale of some businesses. Sales grew, particularly in India, despite a 29 percent drop in China for pharmaceuticals and vaccines.

The British company, with operations in Philadelphia and the region, has been hit by allegations by the Chinese government that four of its employees bribed doctors and hospitals to prescribe medications.

Chief executive Andrew Witty said Wednesday that the company was making fundamental changes to its business, including how it interacts with customers.

The company said in December that it would stop paying doctors to promote its products at speaking engagements and scrap individual sales targets.

Glaxo won approval of two new lung drugs, Breo and Anoro, last year. The company’s top-selling product, Advair for smokers’ cough and asthma, is facing increasing competition from a newly approved generic in Europe and cheaper options in the United States. Glaxo has received “excellent” reaction from physicians to Breo, which is now is covered by 25 percent of Medicare prescription-drug plans in the U.S., Witty said.

“I’m delighted with the progress we’ve made,” Witty told reporters in London. “The demise of GSK Respiratory has often been exaggerated.”

Glaxo won approval for four other new products last year, for skin cancer, HIV and influenza. Albiglutide for Type 2 diabetes was recommended for approval by the European Union’s drug regulator last month, and the company expects data from six late-stage clinical trials this year. Glaxo also plans to start the last phase of human testing for about 10 medicines this year and next.

Pharmaceutical and vaccine sales in China were down 18 percent in the fourth quarter, led by declining sales of treatments for respiratory diseases and hepatitis, after a 61 percent plunge in the previous quarter as the company faces the bribery probe.

AllTrials campaign video coming soon

27th January 2014

In the year since the launch of the AllTrials campaign over 63,000 people have signed the petition and 445 organisations have joined up; MEPs told us that our supporters’ input shaped the new European clinical trials law; and companies, research funders and regulators are having serious discussions about how to implement necessary changes to increase transparency.

This is great progress, but transparency in clinical trials is a global issue and to effect a major and lasting change the campaign has to have success internationally. There are people around the world who want to build the campaign in their own country and we want to help them by producing material they can use.

We launched an appeal for donations in October 2013 to make a short campaign video that gathers together the voices of patients, doctors, campaigners and pharmaceutical companies. You helped us reach our target and we’ve started filming with Rob Frost, Policy Director from the Chief Medical Officers office at GSK; Dr Ben Goldacre, doctor and author; Richard Stephens, cancer patient and trial participant; and Síle Lane, who manages campaigns at Sense about Science and runs AllTrials.

We hope the video will be ready in a few weeks and will be subtitled in many languages to maximise its reach. Thank you to everyone who kindly fundraised for us or donated money to the appeal. We hope you will share the video with your contacts and networks when it’s launched and help us spread the word far and wide.

Here’s a sneak preview from behind the scenes:

Ben Goldacre explains why doctors must have access to all trial results

Síle Lane talks about the importance of publishing all trials, past and present

The team from Red Banana Ltd with Síle and Richard Stephens
after relating his own experiences with clinical trials

Rob Frost explains why GSK joined AllTrials and the importance of transparancy